COVID-19 briefing: Snohomish County pauses adminstration of Johnson & Johnson vaccine

Dr. Chris Spitters

During the weekly Snohomish County briefing on COVID-19, County Health Officer Dr. Chris Spitters announced Tuesday that effective immediately, the county is “putting a pause on the administration of the Johnson & Johnson vaccine.” The rationale, he said, comes from the federal Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) after their safety monitoring system captured six reports of Johnson & Johnson vaccine recipients experiencing blood clots.

All six cases involve a clot in the veins of the brain called a cerebral venous sinus thrombosis among U.S. women between the ages of 18 and 48. Symptoms materialized six to 13 days after they received the Johnson & Johnson vaccination. Spitters emphasized “that this effect appears to extremely rare – six cases with over almost 7 million doses of this vaccine given nationwide” — or approximately one in a million.

Spitters warned that symptoms such as a severe headache, abdominal pain, leg pain or shortness of breath “are all signals of various forms of blood clots forming in the vein.” Anyone experiencing those manifestations within three weeks of receiving the Johnson & Johnson vaccine should contact their health care provider or if the symptoms are severe then either go to the emergency room or call 911.

“It’s not yet been definitively established that these events are connected to the vaccination but certainly the safety signal that it sends warrants further review,” Spitters said. That review involves the CDC convening a meeting of its advisory committee on immunization practices. He noted that the board consists of national experts not employed by the CDC who “are independent academic and other physicians, vaccinologists, other specialists who look at the data on this and render an opinion on the safety concerns that it may raise or not.”

Snohomish County had previously received approximately 24,000 doses of the Johnson & Johnson vaccine — most or all of which have been administered. “We have no reports of safety signals locally with respect to this vaccine,” Spitters said. “Meanwhile it seems prudent to just put a pause on things until that (review) process is complete, hopefully later in the week.”

Spitters said the federal government “has set up a very robust system for detecting these concerns,” and health care providers reporting “any adverse effects occurring during or after the vaccine administration.” People who have been vaccinated are also being encouraged to sign up for V-safe, which is a patient-oriented interface to help the CDC monitor people’s well-being after receiving the vaccination. “Presumably these findings are a result of that strong system,” Spitters added.

Spitters cautioned that “we must also take seriously the potential impact that any false alarm can do by unnecessarily undermining our confidence in what appears to thus far be a safe and effective vaccine or in the overall vaccination effort itself that is essential to our exit from this health, economic and social crisis that has gripped the world for over a year now.”He added that “virtually no medical intervention is 100% free of risk,” noting many vaccines and types of medical interventions that commonly occur “have risks greater than one in a million and benefit-to- risk ratios which are much less favorable than COVID vaccination.”

Spitters also noted that while Snohomish County remains in Phase 3 of Gov. Inslee’s plan for re-opening the state due to the weekly rate of  hospitalizations for COVID-19 per 100,000 people, the county’s rate has recently “gone up a bit. We’re seeing more cases, a few more hospitalizations.” While the county hasn’t seen an increase in deaths or in long-term care facility cases, he said, “these are all signals that we’ve got some rolling back (as individuals, families and communities) to do.”

He recommended people continue to exercise caution and take preventive measures to prevent further spread of the virus. “I would suggest that just because it’s allowed doesn’t mean it’s a good idea,” Spitters said. “Try to keep those face coverings on all the time when you’re not in your home, avoid gatherings and when you do have gatherings try to keep things outside.”

“Let’s try to protect the businesses and all the activity that supports our society that is permitted by Phase 3, but to enable that continue we’ve got to exercise restraint in our personal lives.”

Spitters said weekly reports on the spread of variants of the virus have shown those known as or originally associated with locations in the U.K. and California are “expanding rapidly and are taking up a larger and larger share of the total cases” because “they’re more transmissible” which is why they are now “displacing the other strains that are out there.”

“Let’s try to protect the businesses and all the activity that supports our society that is permitted by Phase 3, but to enable that continue we’ve got to exercise restraint in our personal lives,” he added.

Snohomish County will receive 30,000 doses of vaccines this week, which will be split between the Pfizer and Moderna products. All Johnson & Johnson vaccines that were scheduled to be received have now been put on hold.

At the current rate, Spitters said it will take approximately 10-12 weeks to reach the roughly 650,000 eligible adults in the county. “This is not something that’s going to happen overnight, so we encourage both your patience and perseverance in looking for that spot to get vaccinated,” he said.

Jason Biermann

Jason Biermann, director of the Snohomish County Department of Emergency Management, said the Angel of the Winds mass vaccination site will be temporarily closed due to pausing usage of the Johnson & Johnson vaccine while awaiting “further guidance from Dr. Spitters, the Department of Health and CDC as to when we reopen that.” It was the one fixed site in the county that was using the Johnson & Johnson vaccine and had previously scheduled roughly 2,500 of those doses to be administered there this week.

Biermann said the county will reschedule people throughout the week and also notify them about other potential sites for rescheduling those appointments where they would then receive either the Moderna or Pfizer vaccines. “We’re going to do our best to accommodate them either at another site or the other place where we were using the Johnson & Johnson vaccine was with our mobile teams,” he said. The mobile teams typically serve residents of senior housing, people at adult family homes who are experiencing homelessness, congregate shelters and also reach out to those who are homebound.

“We are making significant progress in our vaccination efforts,” Biermann said, noting that as of last week more than 150,000 Snohomish County residents have been fully vaccinated, which equates to roughly one out of four people who are over age 16.

Snohomish County’s Vaccine Task Force has also been working closely with historically marginalized populations to develop community-based clinics to serve them. Over the last several weeks the task force has conducted outreach to various community organizations to develop a process for them to inform the task force of their interest in having such a clinic.“Today we’ll begin the first review of those organizations who have sent in their interest and then we’ll start scheduling those,” he said.

Biermann said the vaccine task force has currently administered roughly 130,000 doses of the county’s nearly 400,000 total doses given to people. He added, “I will say our progress is limited by supply, that continues to be our largest barrier.”

Those supply limitations come “at a bad time for lots of reasons,” Biermann said, including the fact that as of April 15 anyone who is age 16 or older will be eligible to start receiving vaccinations. “We do expect that there’s going to be a great interest in appointments, I do want to highlight to folks that while everyone will be eligible if they meet those age requirements, the tiers that we had developed were intended to target the folks who are most at risk first — so we’re going to ask that folks be patient to recognize that by design we’re trying to reach the folks who are most at risk.”

He urged continued diligence, adding, “Please don’t get discouraged, I understand folks get frustrated because appointments arrive and get gobbled up very quickly, please be patient.”

Biermann said he felt the county was “lucky that we did not go back to Phase 2, as Dr. Spitters mentioned, our case rates have been climbing, our trajectory is going the wrong way.” He noted three counties in the state were recently rolled back to Phase 2’s greater health restrictions on activities, and said he felt that by doing so Gov. Inslee “has sent a clear message that he’s serious about enforcing the metrics.”

“We do need to expect that if we cross the threshold that we would go back, so wear a mask, maintain distance, don’t congregate especially indoors and get vaccinated when it’s your turn and when appointments are available,” Biermann said. “We have to do everything we can to keep the case rates down so we can continue moving forward and continue our progress back toward the new normal.”

Biermann encouraged people to continue reaching out for appointments by the county’s website or phone number and other various health care providers in the county who are providing vaccinations. He noted that during this week the Arlington and Monroe vaccination sites will be open to administer first and second doses to people. First dose appointments are available at the Boeing Activities Center site and there are other second doses ready to be administered throughout the county.

The locations for vaccinations are listed on the Snohomish Health District’s website, along with the type of vaccine provided and registration links for appointments, at http://bit.ly/snocovaccine. For people who do not have internet access, need language assistance, or have other barriers to online registration, the COVID-19 call center for Snohomish County is available between 8:30 a.m. and 4:30 p.m. Monday through Friday at 425-339-5278.

— By Nathan Blackwell

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